Tata Memorial Hospital

About: Tata Memorial Hospital is a healthcare organization based out in Mumbai, India. It is known for research contribution in the topics: Cancer & Breast cancer. The organization has 3187 authors who have published 4636 publications receiving 109143 citations.

Secondary Prevention of Cervical Cancer: ASCO Resource-Stratified Clinical Practice Guideline

Abstract: PurposeTo provide resource-stratified, evidence-based recommendations on the secondary prevention of cervical cancer globally.MethodsASCO convened a multidisciplinary, multinational panel of oncology, primary care, epidemiology, health economic, cancer control, public health, and patient advocacy experts to produce recommendations reflecting four resource-tiered settings. A review of existing guidelines, a formal consensus-based process, and a modified ADAPTE process to adapt existing guidelines were conducted. Other experts participated in formal consensus.ResultsSeven existing guidelines were identified and reviewed, and adapted recommendations form the evidence base. Four systematic reviews plus cost-effectiveness analyses provided indirect evidence to inform consensus, which resulted in ≥ 75% agreement.RecommendationsHuman papillomavirus (HPV) DNA testing is recommended in all resource settings; visual inspection with acetic acid may be used in basic settings. Recommended age ranges and frequencies by...

An overview of prevention and early detection of cervical cancers

Abstract: Cervical cancer still remains the most common cancer affecting the Indian women. India alone contributes 25.41% and 26.48% of the global burden of cervical cancer cases and mortality, respectively. Ironically, unlike most other cancers, cervical cancer can be prevented through screening by identifying and treating the precancerous lesions, any time during the course of its long natural history, thus preventing the potential progression to cervical carcinoma. Several screening methods, both traditional and newer technologies, are available to screen women for cervical precancers and cancers. No screening test is perfect and hence the choice of screening test will depend on the setting where it is to be used. Similarly, various methods are available for treatment of cervical precancers and the selection will depend on the cost, morbidity, requirement of reliable biopsy specimens, resources available, etc. The recommendations of screening for cervical cancer in the Indian scenario are discussed.

Epidemiology of digestive tract cancers in India IV. Gall bladder and pancreas.

Abstract: Pancreatic cancer is a leading cause of cancer-related deaths in developed countries. Gall bladder cancer is very common in South American countries, around the Mediterranean and in Japan. A majority of patients with these cancers receive only palliative therapy in spite of recent advances in investigation and surgery. Their poor prognosis and increasing incidence in India necessitate a better epidemiologic approach towards their control. This review is based on epidemiological data, publications and abstracts from India. Population-based data reveal that the incidence of gall bladder cancer is very high in northern Indian cities (5-7 per 100,000 women) and low (0-0.7 per 100,000 women) in southern India. The distribution suggests a high-incidence region comprising Uttar Pradesh, Bihar, Orissa, West Bengal and Assam. The cancer is twice more common in women and is the leading cancer among digestive cancers in women in the northern Indian cities of Delhi and Bhopal. There are few analytical data to hypothesize why this geographical predisposition. The high incidence is also observed in north Indian immigrants to the United Kingdom. The incidence of pancreatic cancer is low (0.5-2.4 per 100,000 men and 0.2-1.8 per 100,000 women) in most parts of India. Somewhat higher rates are seen in the male urban populations of western and northern India. Studies from Kerala support an association between tropical pancreatitis and pancreatic cancer. Time trends reveal an increase in the incidence of gall bladder and pancreas cancers; the increase in the former is alarming. We estimate that the approximate annual cancer burden of India in 2001 would include 17,730 cases of gallbladder cancer and 14,230 of pancreatic cancer. Multi-center studies are needed to identify potentially preventable risk factors associated with gall bladder and pancreatic cancer in India.

Breast Cancer in Limited‐Resource Countries: Diagnosis and Pathology

Abstract: � Abstract: In 2002 the Breast Health Global Initiative (BHGI) convened a panel of breast cancer experts and patient advocates to develop consensus recommendations for diagnosing breast cancer in countries with limited resources. The panel agreed on the need for a pathologic diagnosis, based on microscopic evaluation of tissue specimens, before initiating breast cancer treatment. The panel discussed options for pathologic diagnosis (fine-needle aspiration biopsy, core needle biopsy, and surgical biopsy) and concluded that the choice among these methods should be based on available tools and expertise. Correlation of pathology, clinical, and imaging findings was emphasized. A 2005 BHGI panel reaffirmed these recommendations and additionally stratified diagnostic and pathology methods into four levels—basic, limited, enhanced, and maximal—from lowest to highest resources. The minimal requirements (basic level) include a history, clinical breast examination, tissue diagnosis, and medical record keeping. Fine-needle aspiration biopsy was recognized as the least expensive reliable method of tissue sampling, and the need for comparing its clinical usefulness with that of core needle biopsy in the limited-resource setting was emphasized. Increasing resources (limited level) may enable diagnostic breast imaging (ultrasound ± mammography), use of tests to evaluate for metastases, limited image-guided sampling, and hormone receptor testing. With more resources (enhanced level), diagnostic mammography, bone scanning, and an onsite cytologist may be possible. Mass screening mammography is introduced at the maximal-resource level. At all levels, increasing breast cancer awareness, diagnosing breast cancer at an early stage, training individuals to perform and interpret breast biopsies, and collecting statistics about breast cancer, resources, and competing priorities may improve breast cancer outcomes in countries with limited resources. Expertise in pathology was reaffirmed to be a key requirement for ensuring reliable diagnostic findings. Several approaches were again proposed for improving breast pathology, including training pathologists, establishing pathology services in centralized facilities, and organizing international pathology services. �